The tonsils are a pair of flat, ovoid tissues that we usually refer to as the palatine tonsils. In addition to the palatine tonsils, humans also have pharyngeal tonsils, pharyngeal tonsils, and lingual tonsils, which together form the inner ring of the pharyngeal lymphatic ring. The palatine tonsils are a pair of flat, ovoid tissues located within the tonsillar fossa, which has small depressions on its surface called tonsillar crypts. When inflammation occurs in the tonsils, exfoliated epithelium, lymphocytes and bacteria accumulate at the opening of the crypt, at which point a punctate bean-like substance appears on the surface of the tonsils. It is an immune organ that fights bacteria and viruses. The tonsils are an immune active organ that produces lymphocytes and antibodies that function to fight bacteria and viruses and immunize the whole organism.
The oropharynx, which is a necessary route for eating and breathing, is more likely to hide germs and foreign bodies, and the tonsils, in collaboration with the rich lymphoid tissue of the pharynx, perform the task of defense and protection of this particular area. Therefore, for a healthy person, the tonsils are like a gatekeeper, playing a guarding role. The tonsils are prone to inflammation when it is wet, cold and overworked. The oropharynx is susceptible to inflammation caused by germs that may be invasive or hidden in the tonsillar fossa. Under normal circumstances, the epithelial surface of the tonsils is intact and the mucus glands are constantly secreting, so that bacteria can be discharged from the crypt with the shed epithelial cells, thus keeping the body healthy. When the body’s resistance decreases due to cold, humidity, overexertion, excessive smoking and drinking, bacterial reproduction strengthens, the tonsil epithelial defense function weakens, and the glandular secretion function decreases, the tonsils become infected with bacteria and become inflamed.
Tonsillitis is clinically divided into acute and chronic, and the causative agent is mainly Streptococcus hemolyticus, while other bacteria such as Staphylococcus, Pneumococcus, H. influenzae and viruses can also cause it. Acute attacks of tonsillitis: antibiotics are available. The treatment of tonsillitis is divided into two types of non-surgical and surgical treatment.
Non-surgical treatment includes: 1. Medication: acute tonsillitis, chronic tonsillitis acute attacks to antibiotic therapy, the use of drugs to the full amount of the full course.
2, participate in physical exercise, enhance physical fitness, reduce the chances of upper respiratory tract infection.
3. Take vitamin C and other drugs appropriately.
Repeated inflammation, surgical removal is more beneficial to health. The surgical treatment of tonsils is the surgical removal of tonsils. When it comes to surgical treatment of tonsillitis, it is expected that many people will be surprised: “Tonsillitis still needs surgical treatment? Is it that serious? Besides, aren’t the tonsils an immune organ? How can they be removed?” In the clinic, when I mention surgery to remove tonsils to patients who have recurrent tonsillitis, nine times out of ten, parents of both adults and children will say, “The tonsils have an immune function and cannot be removed!” The first half of this statement is correct, but the second half is wrong. In some cases, tonsil removal can be beneficial to health instead!
If the inflammation spreads, it may harm the whole body. Under normal circumstances, the lymphocytes and antibodies of the tonsils destroy or control the germs and maintain the health of the body. However, when the body’s resistance decreases, or when germs attack repeatedly, especially when the number of germs is large and virulent, inflammation of the tonsils can occur, with low fever, cough and sore throat in mild cases; high fever, shortness of breath and even convulsions in severe cases. If treatment is not timely and the body’s resistance is not sufficient to overcome the germs, inflammation can spread to the surrounding tissues and can spread to other organs via the bloodstream, causing inflammation and also causing systemic pathological reactions.
Local complications: Inflammation can spread to the periphery, most commonly peri-tonsillar abscesses; upward to acute otitis media, rhinitis sinusitis; downward to acute laryngitis, bronchitis, pneumonia, etc.
Systemic complications: related to the metabolic reactions of various organs to streptococci. There are acute arthritis, rheumatic fever, acute pericarditis, myocarditis, endocarditis, acute nephritis, etc. Special vigilance should be exercised for sudden death of patients with myocarditis.
Knowing these conditions, it must be clear that the tonsils have become the “culprit” that endangers human health and should be removed at this time. It is also recommended to remove the tonsils when they affect the child’s eating and sleeping. In addition, repeated inflammation of the tonsils causes tonsillar hypertrophy, which can also have serious effects on the child.
Children can have physiological tonsillar hypertrophy, which can be of no concern to parents if there are no obvious symptoms, but can also cause tonsillar hypertrophy if there is repeated inflammation. When children are growing and developing, parents will look at the immune function of the tonsils more seriously, so when will enlarged tonsils negatively affect the growth and development of children?
1, tonsil hypertrophy affects the child’s feeding, manifested as slow eating, the child’s body thin.
2. Tonsil hypertrophy affects speech development, manifesting as slurred speech and unclear spitting.
3, tonsillar hypertrophy leads to breathing disorders during sleep, and if there is adenoid hypertrophy at the same time, snoring will occur, and in severe cases, there is breath-holding and oxygen deprivation, and sleep disturbance. Poor sleep in children will affect the secretion of growth hormone, resulting in slow growth, and lack of oxygen to the brain will affect memory, hyperactivity, grumpiness and inattention. Therefore, when your child has the above conditions appear, as a parent should think well, such tonsils still need to be retained?
These cases should be operated ① Recurrent attacks of acute tonsillitis, more than 4 to 5 times a year, or a history of peri-tonsillar abscess. ②Tonsils that are excessively enlarged and obstruct breathing, swallowing and speech, this phenomenon is more common in children. (③) Those with chronic low fever and no other lesions other than tonsillitis on systemic examination. ④Nephritis and rheumatism due to tonsillitis should be operated electively under the guidance of a doctor.
Acute attack less than 2 weeks, menstrual period should not be operated ①Acute tonsillitis attack less than 2 weeks after. ②Patients with hematopoietic system diseases and hypocoagulability. ③ Significant hypertension, heart disease, tuberculosis. If these patients are operated, it will lead to aggravation of postoperative pharyngitis symptoms. ④Women should not have surgery during menstruation and 3-5 days before menstruation. ⑤ Patients with chronic pharyngitis may not undergo surgery if it is not very necessary, otherwise the symptoms of pharyngitis will be aggravated after surgery.
Minimally invasive surgery can be done for children. Will tonsillectomy be painful and is there a minimally invasive procedure? This question is a common concern. One of my adult patients had a tonsillectomy. This is what he said when he recalled the surgery 5 years ago, “It was worse than death, like a communist being tortured!” He was exaggerating, but tonsillectomy used to be very painful. At that time, it was local anesthesia and the peeling method was used, which caused more bleeding during the operation and severe pain due to wound swelling after the operation. However, with the introduction of advanced technology from abroad, patients no longer have to suffer from this kind of pain when they have their tonsils removed. General anesthesia is very safe and painless for patients during surgery.
I’m sure you now have a general understanding of the function of the tonsils and tonsillitis. Under normal physiological conditions, the tonsils have an immune function and act as a guard for the first gateway to our body, but if the tonsils are repeatedly inflamed and have become a hiding place for bacteria and cause disease in other organs, then we should look at them differently. At this point it is not a guard, but an enemy that harms our body and needs to be removed without hesitation!
For children, if they have recurrent tonsillitis, they need to use antibiotics frequently, and as the saying goes, “medicine is three kinds of poison”. If your child has enlarged tonsils, along with adenoids that cause snoring and breath-holding during sleep, parents should pay more attention to this. Because the sleep disorder will affect the growth and development of the child, lack of oxygen will affect the brain development, leading to hyperactivity and memory loss. At this moment, as loving fathers and mothers, you should consider: “Is it good for the baby to keep such tonsils, or is it harmful to the baby?”
In short, we should oppose both the “harmless theory of surgery”, which is to remove all the tonsils regardless of their indications, and the negative attitude of waiting for the tonsils that are chronically inflamed and affect the baby’s sleep and food.